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Background Breast cancer-related lymphedema (BCRL) is a feared complication for breast cancer patients who have undergone axillary surgery. Although clinical risk factors for BCRL are defined; data are sparse regarding common exposures that might induce incident arm swelling. The goal of this study was to quantify the association between common exposures thought to be potential risk factors, and the occurrence of incident arm swelling, among breast cancer survivors with or at-risk for BCRL. Methods This is a prospective sub-analysis of the PAL trial, a randomized controlled trial of 295 breast cancer survivors. Participants reported their exposure to 30 different potential risk-factors at three month intervals for one year. Incident arm swelling was defined as a ≥5% increase in inter-limb water volume difference between two consecutive time points. Results Twenty-seven participants (9%) experienced incident arm swelling and 268 patients (91%) did not. Sauna use was the only exposure that was significantly predictive of incident arm swelling (p=0.05). Non-White and non-Black participants had a significantly increased risk for experiencing incident arm swelling (p=0.005) for both comparisons. Conclusions In our patient cohort, many common exposures that have been reported to be risk factors did not prove to have a significant predictive relationship for incident arm swelling. This study supports the recommendation that breast cancer patients who have had axillary surgery should avoid sauna use. The results do not confirm the need for other restrictions that may interfere with the quality of life in women with breast cancer.

A case is presented that exemplifies many issues and controversies in the diagnosis and treatment of breast cancer in the very young. This woman was 22 years of age at diagnosis; she initially underwent breast-conservation therapy and adjuvant chemotherapy, retained fertility, had a subsequent uncomplicated pregnancy and delivery, and 7 years later developed a local recurrence in the breast. The discussion addresses risk factors, diagnosis, and treatment of breast cancer in the young; the impact of treatment on fertility; implications regarding pregnancy, and the management of local recurrence after breast conservation.

Percutaneous endoscopic gastrostomy is commonly utilized in patients with head and neck cancer. Tumor at the PEG exit site is a rare occurrence, likely due to direct implantation. We present a case report, review of the relevant literature, discussion of the mechanism of spread, and management.

NSM provides patients with favorable results in psychosocial, sexual, and physical well-being and overall satisfaction. Sexual well-being showed significant improvement for NSM.